Pat Bond Memorial Old Dyke Award
2007 Nomination Form
Please print, complete and submit.

Nominee's Name: ____________________________________________

This nominee meets the following award criteria:

1. Must be an "out" lesbian over the age of 60.

2. Must live in one of the following counties: San Francisco, Marin, Sonoma, Alameda, Contra Costa, San Mateo or Santa Clara.

3. Has made outstanding contributions to the community and has not received adequate recognition for her contributions.

This nominee deserves consideration because of achievements or involvement in - list organization, position, years of service, etc.:

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Use reverse side of page for your additional comments.

Your Name: ____________________________ Street: __________________________________

City: _____________________________________ State: _________________ Zip: __________

Day Phone: _______________Evening Phone: _______________ Email: ___________________

For consideration, please submit this form by July 15, 2007 to:

Pat Bond Award Nomination Committee
NCLR
870 Market Street
San Francisco, CA 94102
E-mail: committee@patbondaward.com